Asian immigrants face mental illness risks of intergenerational conflict, role changes, limited English language proficiency, and discrimination. Yet despite evidence that mental illness prevalence and severity levels are high, there also is evidence that Asians underutilize mental health services. Underutilization of mental health services is related to somatic distress, cultural differences, and stigma. Previous research shows that Asians combine primary-care, physically-oriented self-help sources (i.e. herbs, massage, exercise and dietary changes) and social support in response to symptoms of mental or emotional distress. This study investigates how illness experiences, cultural beliefs about the causes of illness, and social structural factors interact to influence help-seeking for mental or emotional distress. This study uses a multiphase, mixed ethnographic and quantitative, longitudinal design, and systematic sampling (with random start and interval sampling) to examine the influence of culture on distress and help-seeking for 250 Japanese women. The aims are to: 1). Compare characteristics (demographics and distress symptoms) of groups of women with diverse help-seeking profiles; 2). Describe the ethnographic and psychiatric profiles of a sub-sample of 60 highly distressed women (20 women from each of three recruitment sites); 2A). Ethnographic profiles include social networks, distress experiences, cultural interpretations and evaluations, and help seeking patterns; and 2B). Psychiatric profiles include life-time history and current psychiatric diagnoses; and 3). Compare the ethnographic and psychiatric profiles within and across groups. This study uses a multidisciplinary team and rigorous methods to investigate cultural and clinical aspects of Japanese depression. It will identify cultural patterns of help-seeking to facilitate program development; elucidate cultural adaptations for existing psychiatric tools; and refine symptom profiles to improve precision of mental health assessments.